title: Bronchial artery embolization to control hemoptysis: comparison of N-butyl-2-cyanoacrylate and polyvinyl alcohol particles.
abstract: OBJECTIVE
  To retrospectively compare safety and effectiveness of embolic agents polyvinyl alcohol (PVA) particles versus n-butyl-2-cyanoacrylate (NBCA) for bronchial artery embolization (BAE) for control of hemoptysis.
  
  
  METHODS
  Institutional review board approved this retrospective study; informed consent was waived. From January 2005 to December 2008, 406 patients (242 men, 164 women; age range, 6-92 years) with major hemoptysis underwent BAE by using PVA particles (n = 293) or NBCA (n = 113). Technical and clinical success, complications, hemoptysis-free survival rates, and causes of recurrent hemoptysis were compared between PVA and NBCA groups. The differences in hemoptysis-free survival rates were assessed between subgroups stratified to underlying diseases. The predictive factor for recurrent hemoptysis was identified with Cox proportional hazard regression model.
  
  
  RESULTS
  Technical success was achieved in 93.9% (275 of 293) and 96.5% (109 of 113) of patients for PVA and NBCA, respectively (P = .463); clinical success was achieved in 92.2% (270 of 293) and 96.5% (109 of 113) of patients for PVA and NBCA, respectively (P = .180). Overall and major complication rates were not statistically different (overall complication rates: 34.1% for PVA, 31.0% for NBCA; P = .56; major complication rates: 0.3% for PVA, 0% for NBCA; P > .999). The 1-, 3-, and 5-year hemoptysis-free survival rates were, respectively, 77%, 68%, and 66% for PVA and 88%, 85%, and 83% for NBCA (P = .01). Recanalization of previously embolized vessels was more frequent in PVA group (21.5%) than in NBCA group (1.8%; P < .001). NBCA group showed hemoptysis-free survival rates superior to PVA group in patients with bronchiectasis (P = .016). PVA (P = .050) and aspergilloma (P < .001) were predictive factors for recurrent hemoptysis.
  
  
  CONCLUSIONS
  BAE with NBCA provided higher hemoptysis-free survival rates compared with PVA particles without increasing complication rates. This improvement was evident in patients with bronchiectasis and was caused by more durable embolic effect than PVA particles.
  
  
  BACKGROUND
  http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.13130046/-/DC1.
authors.affiliation: Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul Korea.
authors.forename: Sungmin
authors.initials: S
authors.lastname: Woo
authors.forename: Chang Jin
authors.initials: CJ
authors.lastname: Yoon
authors.forename: Jin Wook
authors.initials: JW
authors.lastname: Chung
authors.forename: Sung-Gwon
authors.initials: SG
authors.lastname: Kang
authors.forename: Hwan Jun
authors.initials: HJ
authors.lastname: Jae
authors.forename: Hyo-Cheol
authors.initials: HC
authors.lastname: Kim
authors.forename: Nak Jong
authors.initials: NJ
authors.lastname: Seong
authors.forename: Young-Joo
authors.initials: YJ
authors.lastname: Kim
authors.forename: Young-Nam
authors.initials: YN
authors.lastname: Woo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001981:Bronchial Arteries; D002648:Child; D004621:Embolization, Therapeutic / Q000379:methods*; D004659:Enbucrilate / Q000627:therapeutic use*; D005260:Female; D006469:Hemoptysis / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011142:Polyvinyl Alcohol / Q000627:therapeutic use*; D012008:Recurrence; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D011142:Polyvinyl Alcohol; D004659:Enbucrilate